Altarum: 43 states get failing marks on healthcare price transparency

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Dive Brief:

U.S. consumers, by and large, still don’t have access to comparative healthcare price information, a new Altarum report shows.

Only two states — Maine and New Hampshire — earned an “A” on healthcare price transparency. Maryland and Oregon received a “B” for their efforts, while Colorado, Vermont and Virginia each got a “C.” All of the rest were rated “F.”

Separately, Altarum reported that healthcare spending rose 1.1% in September, compared with the same month the prior year. The price growth just slightly outpaces December 2015’s all-time low of 0.9%.

Dive Insight:

Year-over-year hospital price growth increased to 1.4%, up from 1.3% in August. Price growth in physician and clinical services held steady at 0.5%, while annual drug price growth dropped 1.4% — the lowest since January 2014, the report says.

Altarum attributed the overall slowdown to continued uncertainty around healthcare policy and structural changes in the health sector.

The annual transparency report card, produced by Altarum’s Center for Payment Innovation and the group Catalyst for Payment Reform, looks at how easily consumers can obtain healthcare prices in the various states. States that scored high had consumer-friendly websites with prices for both inpatient and outpatient procedures. High marks were also given for states that required either provider price reporting or an all-payer claims database, and those that included amount paid as well as charged.

“It is more meaningful to see the entire price for a healthcare event or episode than to see only a hospital or facility price, or only a physician price for a specific service,” the report says “A transparency resource that collects and displays only one or the other isn’t giving a healthcare consumer complete data to make an informed decision.”

Surprise billing — where patients treated by an out-of-network provider are billed for an amount above what their insurer paid — is an ongoing problem is healthcare. A National Bureau of Economic Research study found that 22% of patients who sought emergency care at in-network hospitals received care from out-of-network doctors.

Lawmakers in Congress and a number of states are starting to look at the problem, also called balance billing. In Texas, a new law requires freestanding ERs to inform patients about their insurance networks, in hopes of reducing unexpected medical bills.

Last month, Maryland launched a statewide initiative called “Wear the Cost.” Consumers can access a state website to get comparative price information on for common procedures: hip replacement, knee replacement, hysterectomy and vaginal delivery. The site includes both typical costs and costs associated with potentially avoidable complications.